Internist最新文献_第7页

[Treatment of rheumatoid arthritis and spondylarthritis with biologics]. [生物制剂治疗类风湿性关节炎和脊柱炎]。

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Internist Pub Date : 2022-02-01 Epub Date: 2022-01-14 DOI: 10.1007/s00108-021-01248-x

Christoph Fiehn

{"title":"[Treatment of rheumatoid arthritis and spondylarthritis with biologics].","authors":"Christoph Fiehn","doi":"10.1007/s00108-021-01248-x","DOIUrl":"https://doi.org/10.1007/s00108-021-01248-x","url":null,"abstract":"Biologics are an integral part of modern strategies for treatment of rheumatoid arthritis (RA) and spondylarthritis (SpA), including psoriatic arthritis (PsA). Biologics are biotechnologically produced proteins that have inhibiting effects on humoral and cellular components of rheumatic inflammation. Substance classes used in rheumatology are tumor necrosis factor (TNF)-alpha, interleukin (IL)-1, IL‑6, IL-12, IL-17 and IL-23 inhibitors effective against cytokines as well as the T lymphocyte activation inhibitor abatacept and the B lymphocyte-depleting rituximab. There are clear recommendations for the use of biologics for RA patients inadequately responding to one or more conventional synthetic disease-modifying antirheumatic drugs and for ankylosing spondylitis (AS) and nonradiographical axial SpA patients with an inadequate response to at least two nonsteroidal antirheumatic drugs. For PsA the recommended use depends on the most prominent manifestations in each case. Treatment with biologics should follow the treat to target principle, with a defined and validated treatment target. Treatment in cases of RA and SpA should target remission or at least a low or minimum disease activity. The safety of treatment with biologics has been intensively investigated. There are very specific contraindications for individual substance classes with a focus on an increased risk of infections. The standard procedure before starting treatment with biologics includes the exclusion of latent tuberculosis and hepatitis B. The TNF-alpha inhibitors have a protective effect with respect to myocardial infarction, stroke and venous thromboembolism.","PeriodicalId":54924,"journal":{"name":"Internist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

[37/f-One-sided knee joint swelling of unknown origin : Preparation for the medical specialist examination: part 113]. [37/f]不明原因的单侧膝关节肿胀:医学专科检查的准备:第113部分]。

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Internist Pub Date : 2022-02-01 Epub Date: 2021-09-22 DOI: 10.1007/s00108-021-01144-4

Michaela Köhm

引用次数: 0

[79/f-Somnolence, hypernatremia and acute kidney injury during treatment with lithium : Preparation for the medical specialist examination: part 104]. [79/f]锂治疗期间嗜睡、高钠血症和急性肾损伤:医学专家检查的准备:第104部分]。

4区医学

Internist Pub Date : 2022-02-01 Epub Date: 2022-01-14 DOI: 10.1007/s00108-021-01240-5

B Bader

引用次数: 1

Mitteilungen der DGIM. DGIM的消息

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Internist Pub Date : 2022-02-01 DOI: 10.1007/s00108-021-01251-2

引用次数: 0

[85/f-Dysuria and macroscopic hematuria under oral anticoagulation : Preparation for the medical specialist examination: part 118]. [85/f]口服抗凝下排尿困难和肉眼血尿:医学专科检查的准备:第118部分]。

4区医学

Internist Pub Date : 2022-02-01 Epub Date: 2022-01-11 DOI: 10.1007/s00108-021-01231-6

F Peter, C Misgeld

引用次数: 0

[40/m-Flank pain and fever : Preparation for the medical specialist examination: part 117]. [40/m-腹部疼痛和发烧:为医学专家检查做准备:第117部分]。

4区医学

Internist Pub Date : 2022-02-01 Epub Date: 2022-01-20 DOI: 10.1007/s00108-021-01243-2

C Bauer-Büntzel, M Abu-Tair

引用次数: 0

[21/f-Leukopenia, neutropenia and febrile infection : Preparation for the medical specialist examination: part 115]. [21/f]白细胞减少、中性粒细胞减少和发热性感染:为医学专家检查做准备:第115部分]。

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Internist Pub Date : 2022-02-01 Epub Date: 2021-11-03 DOI: 10.1007/s00108-021-01202-x

E L Rückel

引用次数: 0

[Biologics for connective tissue diseases and vasculitides]. [用于结缔组织疾病和血管疾病的生物制剂]。

4区医学

Internist Pub Date : 2022-02-01 Epub Date: 2022-01-14 DOI: 10.1007/s00108-021-01249-w

Bernhard Hellmich, Joerg C Henes

{"title":"[Biologics for connective tissue diseases and vasculitides].","authors":"Bernhard Hellmich, Joerg C Henes","doi":"10.1007/s00108-021-01249-w","DOIUrl":"https://doi.org/10.1007/s00108-021-01249-w","url":null,"abstract":"Despite therapy with glucocorticoids (GC) and conventional immunosuppressants, patients with connective tissue diseases and vasculitides often develop functionally relevant and prognostically unfavourable internal organ damage. Based on new pathogenetic insights, biologics and small molecules have recently been studied as targeted therapies for collagen vascular diseases and vasculitides. The B lymphocyte stimulator antagonist belimumab has been used for the treatment of systemic lupus erythematosus (SLE) for several years and has recently also been approved as an add-on therapy for lupus nephritis. Anifrolumab, an antibody against the type‑1 interferon receptor, has also been shown to be effective in phase III trials for the treatment of SLE. The interleukin (IL)-6-antagonist tocilizumab showed efficacy in the treatment of interstitial lung disease (ILD) in systemic sclerosis (SSc) and thus has been approved in the USA, although the phase III trial had a negative primary endpoint. In Europe the tyrosine inhibitor nintedanib is approved for progressive ILD in SSc. Tocilizumab is approved for the treatment of giant cell arteritis and reduces both the risk of recurrence and the cumulative GC requirement. The B‑lymphocyte depleting antibody rituximab is approved for induction and maintenance therapy of granulomatosis with polyangiitis and microscopic polyangiitis (MPA) and is currently also being investigated for the treatment of eosinophilic granulomatosis with polyangiitis (EGPA). In patients with EGPA, the IL‑5 antibody mepolizumab leads to improved disease control and reduces GC requirements. A phase III trial of the small molecule antagonist avacopan targeting the complement C5a receptor as a replacement for high-dose GC in induction therapy of GPA and MPA met its primary endpoints. Various other biologics and small molecule antagonists are currently in clinical development for several type of vasculitis and collagen vascular diseases, some of them at advanced stages.","PeriodicalId":54924,"journal":{"name":"Internist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[43/m-Obesity and increasing joint pain : Preparation for the medical specialist examination: part 111]. [43/m-肥胖和关节疼痛加剧:为医学专家检查做准备:第111部分]。

4区医学

Internist Pub Date : 2022-02-01 Epub Date: 2022-01-20 DOI: 10.1007/s00108-021-01229-0

G Plitzko, O Mann

引用次数: 0

[25/m-Sexual risk exposure : Preparation for the medical specialist examination: part 114]. [25/m-性风险暴露:为医学专家检查做准备:第114部分]。

4区医学

Internist Pub Date : 2022-02-01 Epub Date: 2021-09-01 DOI: 10.1007/s00108-021-01133-7

H Matthews, S Schmiedel

引用次数: 0